A group of primary care clinicians explain how they sell "healthy lifestyle" suggestions to their patients in the face of conflicting reports.

This week, a study published in JAMA Internal Medicine reported that resveratrol -- an antioxidant found in red wine, chocolate, and grapes and is often touted for its health benefits -- did not boost longevity or lower the risk of disease. However, one prospective study on a cohort of 783 participants living in a single region is hardly definitive.

We asked a group of primary care clinicians for their take on how they communicate with their patients about healthy lifestyle habits when studies with conflicting information are published. This is the question we asked them via email:

How difficult is it to sell "healthy lifestyle" suggestions in the face of conflicting reports, e.g. red wine is good for the heart, or is it? Put down the salt shaker, or just shake less?

This week's participants:

Robert Bowman, MD, a professor of family medicine at the A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA), in Mesa, Ariz.

Garry Souffrant, MD, a clinical associate professor in the department of general medicine at the UT Health Science Center in San Antonio, Texas.

My General Approach

Elise Y. Sadoun, MD: "I try to keep it simple, because most people have problems with inadequate exercise or unhealthy food choices."

Beth Smolko, PA-C: "In primary care, we see the same patients over and over throughout the years. We try to give them the best advice according to EBM [evidence-based medicine], but what happens when that advice changes from year to year? Or what if Dr. Oz disagrees?"

Jordan D. Grumet, MD: "The problem with healthy lifestyle suggestions is that they have become too complicated."

Robert Bowman, MD: "I was never good at sales. My approach is to find out more about what the patient is eating or taking as supplements."

Garry Souffrant, MD: "In The Rio Grande Valley (in South Texas) the culture is very different. Selling "healthy lifestyle" is very hard. As physicians we have to navigate daily between a patient's own agenda and targeted goals for diabetes, hypertension, and health maintenance. How do I tell someone not to take the 99¢ breakfast at McDonald's when they have a budget of $5 for the day with five kids to feed?"

Words of Wisdom

Sadoun: "I advise patients to walk, even if it's just around the mall, stop all calorie-containing drinks except for milk, eat more veggies and fruits, and use extra virgin olive oil for all cooking. These are easy for patients to understand and remember."

Smolko: "I've found it's better to give general 'healthy lifestyle' suggestions than specific products or data. When patients ask 'What's the best way to lose weight?' I tell them it's an age-old equation involving calories-in and exercise. Most of them grin because they already know the answer to that question. They just wish the 'magic pill' they heard about would be a better option."

Bowman: "I tie [my guidance] in to recent media such as the "60 Minutes" recent segment on living longer and better. I encourage them to access these online. I cannot win against those that advertise drugs and "health foods," but I can help steer patients to the best sources of information. You can help patients with pain to understand foods and substances that are pro-inflammatory (smoking) that can make their pain experience worse."

Souffrant: "When the patient leaves the office, he or she goes back to their reality. How long our intervention lasts sometimes depends on how good a salesman we are. It is difficult for people to stick with a daily regimen. I do not give a diet. I give choices based on today's evidence.

These are the techniques that I use:

Try to be upbeat at all time.

Give a sense of confidence to the patient.

Make sure to connect with the patient's situation.

Motivational interviewing techniques are always good.

Meet the patient halfway.

Do not overwhelm the patient in one session; Rome was not built in one day.

Use a role model the patient can [emulate], especially another patient who has achieved lifestyle changes."

Friday Feedback is a feature that presents a sampling of opinions solicited by MedPage Today in response to a healthcare issue, clinical controversy, or new finding reported that week. We always welcome new, thoughtful voices. If you'd like to participate in a Friday Feedback issue, reach out to e.chu@medpagetoday.com or @elbertchu.

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